Provider Demographics
NPI:1326372731
Name:NWAOKELEMEH, ANGELITA
Entity Type:Individual
Prefix:
First Name:ANGELITA
Middle Name:
Last Name:NWAOKELEMEH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7120 MCCART AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76133-7298
Mailing Address - Country:US
Mailing Address - Phone:817-294-5624
Mailing Address - Fax:817-294-4711
Practice Address - Street 1:7120 MCCART AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76133
Practice Address - Country:US
Practice Address - Phone:817-294-5624
Practice Address - Fax:817-294-4711
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX773419363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX773419Other1326372731